{"id":1832,"date":"2008-10-01T01:00:00","date_gmt":"2008-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/la-colite-microscopique-est-une-cause-frequente-de-diarrhee-chronique-dorigine-medicamenteuse-etude-retrospective-dune-cohorte-de-42-cas\/"},"modified":"2018-10-20T18:39:44","modified_gmt":"2018-10-20T16:39:44","slug":"la-colite-microscopique-est-une-cause-frequente-de-diarrhee-chronique-dorigine-medicamenteuse-etude-retrospective-dune-cohorte-de-42-cas","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/la-colite-microscopique-est-une-cause-frequente-de-diarrhee-chronique-dorigine-medicamenteuse-etude-retrospective-dune-cohorte-de-42-cas\/","title":{"rendered":"La colite microscopique est une cause fr\u00e9quente de diarrh\u00e9e chronique d\u2019origine m\u00e9dicamenteuse : \u00e9tude r\u00e9trospective d\u2019une cohorte de 42 cas."},"content":{"rendered":"<p><strong>2008<\/strong><\/p>\n<p><em>Gilles Macaigne, Marie-Luce Auriault, Jean-Fran\u00e7ois Boivin, Sadek Cheiab, Dorian Dikov, Claude Chayette, Renaud Deplus. Services d\u2019h\u00e9pato-gastroent\u00e9rologie et d\u2019anatomo-pathologie, centre hospitalier de Lagny-Marne-la-Vall\u00e9e, 77 405 Lagny-sur-Marne Cedex.<\/em><\/p>\n<p><strong>Gastroent\u00e9rologie <\/strong>&#8211; \u00a02008-05-14 &#8211;\u00a0Cho &#8211;<\/p>\n<p>________________________________<\/p>\n<p>introduction<br \/>\nLe but de ce travail a \u00e9t\u00e9 d\u2019\u00e9valuer r\u00e9trospectivement les caract\u00e9ristiques d\u2019une cohorte de malades ayant une colite microscopique (CM), lymphocytaire (CL) et collag\u00e8ne (CC), diagnostiqu\u00e9e dans un service de gastro-ent\u00e9rologie de centre hospitalier g\u00e9n\u00e9ral.<\/p>\n<p>Malades et m\u00e9thodes<br \/>\nChez les malades ayant un bilan endoscopique pour une diarrh\u00e9e chronique d\u00e9finie par une modification de la consistance des selles et\/ou une augmentation du nombre de selles (&gt;3\/j) pendant plus de 3 semaines, des biopsies coliques \u00e9tag\u00e9es, il\u00e9ales, duod\u00e9nales et gastriques ont \u00e9t\u00e9 r\u00e9alis\u00e9es de fa\u00e7on syst\u00e9matique. Tous les malades chez qui le diagnostic de CM a \u00e9t\u00e9 retenu entre juin 1999 et avril 2008 ont \u00e9t\u00e9 inclus dans l\u2019analyse. Le diagnostic de CL \u00e9tait \u00e9voqu\u00e9 en cas d\u2019augmentation du nombre de lymphocytes intra-\u00e9pith\u00e9liaux sup\u00e9rieur \u00e0 20 pour 100 cellules \u00e9pith\u00e9liales, le diagnostic de CC \u00e9tant port\u00e9 en cas d\u2019\u00e9paississement de la membrane basale \u00e9pith\u00e9liale sup\u00e9rieur \u00e0 10 \u00b5m.<\/p>\n<p>R\u00e9sultats<br \/>\nLe diagnostic de CM (20 CC et 22 CL) a \u00e9t\u00e9 retenu chez 42 malades, dont 74% de femmes (73% en cas de CC et 71% en cas de CL), d\u2019\u00e2ge moyen  62.2 ans, l\u2019\u00e2ge moyen n\u2019\u00e9tant pas statistiquement diff\u00e9rent entre les 2 types de CM. La dur\u00e9e m\u00e9diane de la diarrh\u00e9e avant le diagnostic de CM \u00e9tait de 3 mois (1 \u2013 180). Dans 43% des cas, la CM a \u00e9t\u00e9 attribu\u00e9e \u00e0 un m\u00e9dicament (36% pour les CL et 50% pour les CC) (p=0.08). En l\u2019absence de cause m\u00e9dicamenteuse, un contexte dysimmunitaire personnel ou familial (parent de premier degr\u00e9) \u00e9tait retrouv\u00e9 dans 50% des cas versus seulement 5% en cas de cause m\u00e9dicamenteuse \u00e0 la CM (p=0.01). En l\u2019absence de cause m\u00e9dicamenteuse, une maladie coeliaque \u00e9tait associ\u00e9e \u00e0 la CM dans 4 cas (16,6%) et une dysthyro\u00efdie dans 3 cas (12,5%). Parmi les autres pathologies associ\u00e9es, il \u00e9tait not\u00e9 une gastrite auto-immune de Biermer, une h\u00e9patopathie chronique d\u2019origine ind\u00e9termin\u00e9e, une pathologie rhumatologique inflammatoire avec pr\u00e9sence d\u2019auto-anticorps, un diab\u00e8te insulino-d\u00e9pendant et une maladie de Chester-Erheim, un malade \u00e9tant VIH positif. Une malade avait un \u00e9paississement diffus du collag\u00e8ne sous-\u00e9pith\u00e9lial (colon, il\u00e9on, estomac) et 5 malades avaient un ant\u00e9c\u00e9dent familial chez un parent de premier degr\u00e9 de CL (n=1), de maladie coeliaque ou d\u2019atrophie villositaire duod\u00e9nale d\u2019\u00e9tiologie ind\u00e9termin\u00e9e (n=3), de maladie de Crohn (n=1).<\/p>\n<p>Conclusion<br \/>\nEn cas de diarrh\u00e9e chronique, le diagnostic de CM doit \u00eatre recherch\u00e9 syst\u00e9matiquement par la r\u00e9alisation de biopsies coliques \u00e9tag\u00e9es. Une \u00e9tiologie m\u00e9dicamenteuse doit syst\u00e9matiquement \u00eatre \u00e9voqu\u00e9e en cas de CM, 43% d\u2019entre-elles \u00e9tant d\u2019origine iatrog\u00e8ne et tout m\u00e9dicament introduit dans les 3 \u00e0 6 mois pr\u00e9c\u00e9dant le d\u00e9but de la diarrh\u00e9e doit \u00eatre suspect\u00e9. Enfin, en l\u2019absence de cause m\u00e9dicamenteuse, la CM est associ\u00e9e \u00e0 un contexte dysimmunitaire dans 50% des cas, une maladie coeliaque \u00e9tant retrouv\u00e9e dans pr\u00e8s de 17% des cas de CM sans \u00e9tiologie m\u00e9dicamenteuse.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2008 Gilles Macaigne, Marie-Luce Auriault, Jean-Fran\u00e7ois Boivin, Sadek Cheiab, Dorian Dikov, Claude Chayette, Renaud Deplus. Services d\u2019h\u00e9pato-gastroent\u00e9rologie et d\u2019anatomo-pathologie, centre hospitalier de Lagny-Marne-la-Vall\u00e9e, 77 405 Lagny-sur-Marne Cedex. Gastroent\u00e9rologie &#8211; \u00a02008-05-14 &#8211;\u00a0Cho &#8211; ________________________________ introduction Le but de ce travail a \u00e9t\u00e9 d\u2019\u00e9valuer r\u00e9trospectivement les caract\u00e9ristiques d\u2019une cohorte de malades ayant une colite microscopique (CM), lymphocytaire [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[19],"class_list":["post-1832","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-19"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>La colite microscopique est une cause fr\u00e9quente de diarrh\u00e9e chronique d\u2019origine m\u00e9dicamenteuse : \u00e9tude r\u00e9trospective d\u2019une cohorte de 42 cas. - 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